Evaluation of Predisposing Risk Factors for Gallstone Formation Following Bariatric Surgery


ABSTRACT:BACKGROUND:The risk factors for development of gallstones have been studied extensively in the generalpopulation. They are different when it comes to patients who underwent bariatric operations.Obesity and rapid weight loss induced by weight-reducing surgery are well recognized for thedevelopment of gallbladder stones. There is no standard policy whether to perform prophylacticcholecystectomy at the time of the bariatric operation or to give postoperative treatment to decreasethe risk.OBJECTIVE:The aim of the study is to evaluate the predictors of gallstone formation post-Bariatric surgery andassociated risk factors. The implication behind it will help decide how to follow up postoperativelyand whom are at increased risk to develop cholelithasis.METHODS:This prospective study was performed on 100 patients who underwent weight-reducing operationsat Al-Imamain Al-Kadimiyen Teaching Hospital. They were followed for 12 monthspostoperatively. Ultrasonography examination was done for those who developed symptomssuggestive of gallstone formation.RESULTS:Twenty percent of them were found to have gallstones. Of the the parameters enrolled in the study(age, gender, type of surgery, preoperative body mass index, percentage of excess body weightloss), only the factor of the percentage of excess weight loss was the most significant of predictingdevelopment of gallstone post-bariatric procedures (p value = 0.002). The preoperative BMI, age,gender and type of operation were found were not found to be statistically significant in terms of itsrelationship with gallstone formation.CONCLUSION :Concomitant cholecystectomy along with the bariatric procedure is not recommended. Surveillanceby ultrasonography for those with excess weight loss more than 25% of their original weight isadvised for 1 year postoperatively.